Provider Demographics
NPI:1225692999
Name:CHRISTIANSON, ALLISON BLOMQUIST (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:BLOMQUIST
Last Name:CHRISTIANSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17218 S RAMSBY RD
Mailing Address - Street 2:
Mailing Address - City:MOLALLA
Mailing Address - State:OR
Mailing Address - Zip Code:97038-7634
Mailing Address - Country:US
Mailing Address - Phone:503-616-1101
Mailing Address - Fax:503-334-4379
Practice Address - Street 1:201 B AVE STE 295
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3290
Practice Address - Country:US
Practice Address - Phone:503-616-1101
Practice Address - Fax:503-334-4379
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-27
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL81181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical